Hubby got insurance packet today & we are doing some research to see if we can get some of my Diabetic supplies at a cheaper cost. I'm currently on Humalog insulin and we got to thinking and I don't really know why doctors decided to put me on Humalog. None of them EVER explained to me why exactly they chose to put me on Humalog over other insulin. I've changed through many doctors over the years, I've never had a GREAT doctor that would sit down and explain stuff to me. And I was wondering is it the ONLY fast acting insulin that I can use?! Or how is it price wise to all the other fast acting insulin's out there? I know a lot of you are on insulin pumps and aren't taking the same insulin as me. So I was just wondering, I currently have united healthcare (PPO Plan) as insurance & I'm a type one diabetic. Me & DH like to be cost efficient to get the best bang for our buck and don't want to get screwed when it comes to ordering my supplies.
It really depends on your insurance coverage, Jessica. Some insurance list some meds as their preferred brand at lower cost, and other brands at a higher cost. So you should check it out with them. Apidra has had a "no co-pay" coupon that was available all of 2012 and 2013, which was great, but I have no idea of whether they will be continuing this. You could check their website.
Some of us prefer one of the three fast acting insulins to the others, but the differences are minor, so I would recommend just checking with your insurance to see if there is a cost difference for you.
Doctors will primarily respond to issues that you report as problems, so explaining why you are using a particular insulin probably wouldn't come up unless you ask, or if you were having some type of allergic reaction or unusual response to your insulin.
If your insurance plans have on-line websites for details of your coverage, look for the 'formulary'. This will show which medications/insulins/BG strips, etc are covered, and if there is a different 'tier' or preferred/non-preferred distinction, with different coverage. My insurance website actually has an option to enter in the drug name, qty, etc, and it will show me the price if I order it via their mail service option. I can usually get 3 months supply via mail, for the same cost as 2 months from local pharmacy.
Another suggestion is to check with your local pharmacy, and ask the pharmacist about comparable products/alternatives. They might be better at explaining it than the doctors !
For my insurance, Humalog is not covered at all, just Novolog. But 3 years ago they would cover either one. This seems to be the trend - to limit the products covered, when there are different brands they feel are 'equal'.
I have Aetna and I save significantly by ordering my prescriptions from their mail order pharmacy where I can get a 90 day prescription filled for a single co-pay. As has been suggested, every insurance company and every plan could have different benefits and formularies, so you need to check your particular case.
Normally through mail order I get a 90 day supply of insulin & strips. This last time I ordered I got 10 bottles of humalog for $10.00 and 600 strips for $100.00 so every 3 months I’m spending $200.00 on my supplies.
The limitation is because of a contract between the insurance company and the supplier.
Absent rare allergy or efficacy issues, Humalog, Novolog, and Apidra are all pretty much the same in terms of treatment. For the vast, vast majority of diabetics, the generic, "rapid-acting insulin" applies -- doesn't matter which one they use.
An insurer will try to strike a deal with each of these manufacturers. The incentive for the insurer is minimizing cost (price). The incentive for the manufacturer is exclusivity, bringing a large batch of guaranteed customers.
So, a deal is struck, and choice is then limited to one "approved" rapid-acting insulin.
We as diabetics are very wrong to resent this. The insurance company is getting the best deal on your behalf that it can, keeping your premiums and copays lower as a result (in general, of course).
None of this matters unless you're one of the few people that react badly to the chosen insulin. In such cases, virtually always, one can get approval from the same insurance company for a non-formulary brand. It may cost a bit more (no contract with supplier), and there will be a hassle to "prove" that you can't use what's approved.
Well actually I do resent some of this. I don't like insurance companies negotiating a price. There should be one price. There shouldn't be tiered pricing and there shouldn't be reverse progressive pricing (where poor people with no insurance pay very high prices). I actually don't believe insurance companies have any incentive to control costs since they just pass on the costs to all of us in terms of increased premiums. Just my opinion.
